Triamcinolone acetonide topical

Kenalog®, Trianex®

Uses: Inflammatory dermatoses responsive to steroids

MOA: Inhibits multiple inflammatory cytokines, produces multiple glucocorticoid and mineralocorticoid effects

Dose: Apply q day-qid

Caution: C, ?/-, w/ skin infxn

CI: Component allergy

Disp: Cream, Oint 0.025%, 0,1%, 0.5%; Lotion 0.025%, 0.1%

SE: burning, itching, irritation, dryness, folliculitis, hypertrichosis, hypopigmentation

Digoxin

Lanoxin®, Lanoxicaps®, Digitek®

Uses: *CHF, AF, A flutter, PAT*

MOA: Positive inotrope; ↑ AV node refractory period

Dose: Adults: PO Digitalization: 0.5-0.75 mg PO, then 0.25 mg PO q6-8h to total 1-1.5 mg, IV or IM Digitalization: 0.25-0.5 mg IM or IV, then 0.25 mg q4-6 to total 0.125-0.5 mg/d PO, IM, or IV (average daily dose 0.125-0.25 mg)

Caution: C, +, w/ ↓ K+, Mg2+, renal failure

CI: AV block, idiopathic hypertrophic subaortic stenosis, constrictive pericarditis

Disp: Caps 0.05, 0.1, 0.2 mg; tabs 0.125, 0.25, 0.5 mg, elixir 0.05 mg/mL; Inj 0.1, 0.25 mg/mL

SE: Can cause heart block, ↓ K+ potentiates tox, N/V, HA, fatigue, visual disturbances (yellow-green halos, around lights), cardiac arrhythmias

Notes: Multiple drug interactions, IM inj painful, has erratic absorption & should not be used. Levels: Trough: Just before next dose; Therapeutic: 0.8-2 ng/mL, Toxic: >2 ng/mL, 1/2 life: 36h

Lamotrigine

Lamictal®

BBW: Serious rashes requiring hospitalization & DC of Rx reported, rash less frequent in adults, ↑ risk of suicidality for antiepileptic drug, higher for those w/ epilepsy vs. those using drug for psychological indications

Uses: *Partial szs, tonic-clonic szs, bipolar disorder, Lennox-Gastaut synd*

MOA: Phenyltriazine, antiepileptic, ↓ glutamate, stabilize neuronal membrane

Dose: Adults: Szs: Initial 50 mg/d PO, then 50 mg PO bid for x 1-2wks, maint 300-500 mg/d in 2 ÷ doses, Bipolar: Initial 25 mg/d PO x 1-2 wks, 50 mg PO daily for 2 wks, 100 mg PO daily for 1 wk, maint 200 mg/d

Caution: C, -, interactions w/ other antiepileptics, estrogen, rifampin

Disp: Tabs 25, 100, 150, 200 mg, chew tabs 2, 5, 25 mg (color-coded for those on interacting meds)

SE: Photosens, HA, GI upset, dizziness, diplopia, blurred vision, blood dyscrasias, ataxia, rash (may be much more life threatening to peds than to adults), aseptic meningitis

Notes: Value of therapeutic monitoring uncertain, taper w/ DC 

Cefdinir

Omnicef®

Uses: *Infxns of the resp tract, skin, bone, & urinary tract*

MOA: 3rd gen cephalosporin; ↓ cell wall synthesis; Spectrum: Many gram (+) & (-) organisms; more active than cefaclor & cephalexin against Streptococcus, Staphylococcus, some anaerobes

Dose: Adults: 300 mg PO bid or 600 mg/d Peds: 7 mg/kg PO bid or 14 mg/kg/d; ↓ in renal impair

Caution: B, +, w/ PCN-sensitive pts, serum sickness-like rxn reported

CI: Hypersensitivity to cephalosporins

Disp: Caps 300 mg, Susp 125, 250 mg/5 mL

SE: Anaplylaxis, D, rare pseudomembranous colitis

Diltiazem CD

Cardizem® CD

Uses: *Angina, prevention of reinfarction, HTN, AF, A flutter, & PAT*

MOA: CCB

Dose: 120-360 mg/d (max 540 mg/d)

Caution: C, +, ↑ effect w. amiodarone, cimetidine, fentanyl, Li, cyclosporine, digoxin, beta blockers, theophylline

CI: SSS, AV block, ↓ BP, AMI, pulm congestion

Disp: Caps 120, 180, 240, 300 mg

SE: Gingival hyperplasia, ↓ HR, AV block, ECG abnormalities, peripheral edema, dizziness, HA

Notes: Cardizem CD, Dilacor XR & Tiazac are not interchangeable

Benazapril

Lotensin®

Uses: *HTN*, DN, CHF

MOA: ACE Inhib

Dose: 10-80 mg/d PO

Caution: C/D/D, +

CI: Angioedema, Hx edema, bilateral RAS

Disp: Tabs 5, 10, 20, 40 mg

SE: Symptomatic ↓ BP w/ diuretics, dizziness, HA, ↑ K+, nonproductive cough

Topiramate

Topamax®

Uses: *Adjunctive Rx for complex partial Szs & tonic-clonic Szs*, bipolar disorder, neuropathic pain, migraine prophylaxis

MOA: Anticonvulsant

Dose: Adults: Neuropathic pain, Szs: Total dose 400 mg/d; see PI for 8 wk titration schedule. Migraine prophylaxis: titrate 100 mg/d total

Caution: C, ?/-

CI: Component allergy

Disp: Tabs 25, 50, 100, 200 mg, cap sprinkles 15, 25, 50 mg

SE: Wgt loss, memory impair, metabolic acidosis, kidney stones, fatigue, dizziness, psychomotor slowing, paresthesias, GI upset, tremor, nystagmus, acute glaucoma requiring DC

Notes: Metabolic acidosis responsive to ↓ dose or DC, DC w/ taper

Isosorbide mononitrate

Imdur®

Uses: *Prevention/Rx of angina pectoris*

MOA: Relaxes vascular smooth muscle

Dose: 5-10 mg PO bid, w/ the 2 doses 7 hrs apart or XR (Imdur) 30-60 mg/d PO, max 240 mg

Caution: C, ?

CI: Head trauma/cerebral hemorrhage (can ICP), w/ sildenafil, tadalafil, vardenafil

Disp: Tabs 10, 20 mg, XR 30, 60, 120 mg

SE: HA, dizziness, ↓ BP

Ramipril

Altace®

BBW: ACE inhib used during PRG can cause fetal injury & death

Uses: *HTN, CHF, DN, post-MI*

MOA: ACE inhib

Dose: 2.5-20 mg/d PO ÷ daily-bid; ↓ in renal failure

Caution: D, +

CI: ACE-inhib induced angioedema

Disp: Caps 1.25, 2.5, 5, 10 mg

SE: Cough, HA, dizziness, ↓ BP, renal impair, angioedema

Notes: OK in combo w/ diuretics

Risperidone

Risperidal®, Risperidal® M-Tab

BBW: ↑ Mortality in elderly w/ dementia-related psychosis

Uses: *Psychotic disorders (schizophrenia)*, dementia of the elderly, bipolar disorder, mania, Tourette disorder, autism

MOA: Benzisoxazole antipsychotic

Dose: Adults: 0.5-6 mg PO bid, M-Tab: 1-6 mg start 1-2 mg/d, titrate q3-7 d

Caution: C, -, ↑ BP w/ antihypertensives, clozapine

CI: Component allergy

Disp: Tabs 0.25, 0.5, 1, 2, 3, 4 mg; soln 1 mg/mL, M-Tab 0.5, 1, 2, 3, 4 mg

SE: Orthostatic ↓ BP, EPS w/ high dose, tachycardia, arrhythmias, sedation, dystonias, neuroleptic malignant syndrome, sexual dysfunction, constipation, xerostomia, ↓ WBC, neutropenia, agranulocytosis, cholestatic jaundice

Notes: Serveral wk for effect

Glyburide

DiaBeta®, Micronase®, Glynase®

Uses: *Type 2 DM*

MOA: Sulfonylurea; ↑ pancreatic insulin release, ↑ peripheral insulin sensetivity, ↓ hepatic glucose output/production, ↓ intestinal glucose absorption

Dose: 1.25-10 mg daily-bid, max 20 mg/d. Micronized: 0.75-6 mg daily-bid, max 12 mg/d

Caution: C, ?, renal impair, sulfonamide allergy

CI: DKA, type 1 DM

Disp: Tabs 1.25, 2.5, 5 mg; micronized tabs 1.5, 3, 6 mg

SE: HA, hypoglycemia, cholestatic jaundice, and hepatitis may cause liver failure

Notes: Not OK for CrCl <50 mL/min; hold dose if NPO; hypoglycemia may be difficult to recognize; many medications can enhance hypoglycemic effects

Penicillin VK

Pen-Vee K®

Uses: Susceptible streptococcal infxns, otitis media, URIs, skin/soft-tissue infxns (PCN-sensitive staphylococci)

MOA: Bactericidal; ↓ cell wall synthesis. Spectrum: Most gram (+), including streptococci

Dose: Adults: 250-500 mg PO q6h, q8h, q12h, ↓ in renal impair; take on empty stomach

Caution: B, M

CI: Allergy

Disp: Tabs 125, 250, 500 mg; susp 125, 250 mg/5mL

SE: GI upset, intersitial nephritis, anaphylaxis, convulsions

Notes: Well-tolerated PO PCN; 250 mg= 400,000 units of PCN G

Lansoprazole

Prevacid®

Uses: *Duodenal ulcers, prevent & Rx NSAID gastric ulcers, active gastric ulcers, H. pylori infxns, erosive esophagitis & hyperscretory conditions, GERD*

MOA: Proton pump inhib

Dose: 15-30 mg/d PO; NSAID ulcer prevention: 15 mg/d before food; 30 mg IV daily= 7 d change to PO for 6-8 wk; ↓ w/ severe hepatic impair

Caution: B, ?/-, may ↓ effect of Plavix

Disp: Prevacid: DR caps 15, 30 mg; ODT: 15, 30 mg (contains phenylalanine), IV 30 mg

SE: N/V, Abd pain, HA, fatigue

Notes: For IV provided inline filter must be used; do not crush/chew; granules can be given w/ applesauce or apple juice (NG tube) only; ? ↑ risk of fractures w/ all PPI

Clindamycin

Cleocin®

BBW: Pseudomembranous colitis may range from mild to life-threatening

Uses: *Rx aerobic & anaerobic infxns, topical for severe acne & vag infxns*

MOA: Bacteriostatic; interferes w/ protein synth. Spectrum: Streptococci, pneumococci, staphylococci & gram (+) & (-) anaerobes; no activity against gram (-) aerobes

Dose: Adults: PO: 150-450 mg PO q6-8h. IV:  300-600 mg IV q6h or 900 mg IV q8h. Vaginal: 1 applicator hs for 7 days. Topical: Apply 1% gel lotion, or soln bid

Caution: B, +, Can cause fatal colitis

CI: Hx pseudomembranous colitis

Disp: Caps 75, 150, 300 mg; susp 75 mg/5 mL; Inj 300 mg/2 mL; vag cream 2%; top soln, gel, lotion 1%; vag supp 100 mg

SE: D may be C. difficile pseudomembranous colitis, ↑ LFTs, rash

Notes: D/C drug w/ D, evaluate for C. difficile

Bupropion XL

Wellbutrin® XL

BBW: All pts being treated w/ buproprion for smoking cessation Tx should be observed for neuropsychiatric S&Sxs (hostility, agitation, depressed mood, and suicide-related events; most during/after Zyban; Sxs may persist following DC; Closely monitor for worsening depression or emergence of suicidality, increased suicidal behavior in young adults

Uses: *Depression, smoking cessation adjunct*, ADHD

MOA: Weak inhib of neuronal uptake of serotonin & NE; ↓ neuronal dopamine reuptake

Dose: Depression: 100-450 mg/d ÷ bid-tid; XL: 150-450 mg/d. Smoking cessation: 150 mg/d x 3d, then 150 mg bid x 8-12 wks, last dose before 6 pm; ↓ dose w/ renal/hepatic impair

Caution: C, ?/-

CI: Sz disorder, Hx anorexia nervosa or bulimia, MAOI w/ or w/in 14 d; abrupt DC of EtOH or sedatives; inhibitors/inducers of CYP 2B6; w/ ritonavir and lopinavir/ritonavir

Disp: Tabs 75, 100 mg; SR tabs 100, 150, 200 mg; XL tabs 150, 300 mg; Zyban 150 mg tabs

SE: Szs, agitation, insomnia, HA, tachycardia, ↓ wgt

Notes: Avoid EtOH & other CNS depressants, SR & XR do not crush/chew/cut, may ↑ adverse events including szs

Metronidazole

Flagyl®, Metrogel®

BBW: Carcinogenic in rats

Uses: *Bone/joint, endocarditis, intra-Abd, meningitis, & skin infxns; amebiasis and amebic liver abcess; trichomoniasis in pt and partner; bacterial vaginosis; PID; giardiasis; antibiotic associated pseudomembranous colitis (C. difficle), eradicate H. pylori w/ combo Rx, rosacea, prophylactic in post-op colorectal surgery*

MOA: Interfers w/ DNA synthesis, Spectrum: Excellent anaerobic, C. difficile

Dose: Adults: Anaerobic infxns: 500 mg IV q6-8h. Amebic dysentery: 500-750 mg/d PO q8h x 5-10 d. Trichomonas: 250 mg PO tid for 7 d or 2 g PO x 1 (Rx partner). C difficile: 500 mg PO or IV q8h for 7-10 d (PO preferred; IV only if pt is NPO), if no response switch to PO vanco. Vaginosis: 1 applicator intravag q day or bid x 5d, or 500 mg PO bid x 7 d or 750 mg PO q day x 7 d. Acne rosacea/skin: Apply bid. Giardia: 500 mg PO bid x 5-7 d. H pylori: 250-500 mg PO w/ meals & hs x 14 d, combine w/ other antibiotic & a PPI or H2 antagonist, ↓ w/ severe hepatic/renal impair

Caution: B, +/-, Avoid EtOH, w/ warfarin, CYP 3A4 substrates, ↑ Li levels

CI: First tri of PRG

Disp: Tabs 250, 500 mg; XR tabs 750 mg; caps 375 mg; IV 500 mg/100 mL; lotion 0.75%; gel 0.75, 1%; intra vag gel 0.75%; cream 0.75, 1%

SE: Disulfuram-like rxns, dizziness, HA, GI upset, anorexia, urine discoloration, flushing, metallic taste

Notes: For trichomoniasis, Rx pts partner, no aerobic bacteria activity, use in combo w/ serious mixed infxns, wait 24 h after 1st dose to breast-feed or 48h if extended Rx, take ER on empty stomach

Glipizide

Glucotrol®, Glucotrol® XL

Uses: *Type 2 DM*

MOA: Sulfonylurea; ↑ peripheral insulin sensitivity; ↓ hepatic glucose output/production, ↓ intestinal glucose absorption

Dose: 5 mg initial, ↑ by 2.5-5 mg/d, max 40 mg/d; XL max 20 mg/d; 30 min ac; hold if NPO

Caution: C, ?/-, severe liver Dz

CI: DKA, type 1 DM, sulfonamide sensitivity

Disp: Tabs 5, 10mg; XL 2.5, 5, 10 mg

SE: HA, anorexia, N/V/D, constipation, fullness, rash, urticaria, photosens

Notes: Counsel about DM management, wait several days before adjusting dose, monitor glucose

Divalproex sodium

Depakote®, Depakene®

BBW: Fatal hepatic failure (usually during 1st 6 mo of tx, peds < 2 yrs high risk, monitor LFTs at baseline and frequent intervals), teratogenic effects, and life-threatening pancreatitis reported

Uses: *Rx epilepsy, mania, prophylaxis of migraines*, Alzheimer behavior disorder

MOA: Anticonvulsant; ↑ availability of GABA

Dose: Szs: 30-60 mg/kg/24 h PO ÷ tid (after initiation of 10-15 mg/kg/24 h) Mania: 750 mg in 3 ÷ doses, ↑ 60 mg/kg/d max. Migraines: 250 mg bid, ↑ 1000 mg/d max; ↓ w/ hepatic impair

Caution: D, +, multiple drug interactions

CI: Severe hepatic impair, urea cycle disorder

Disp: Caps 250 mg; Caps w/ coated particles 125 mg; tabs DR 125, 250, 500 mg; tabs ER 250, 500 mg; Caps DR 125, 250, 500 mg; syrup 250 mg/5 mL; Inj 100 mg/mL

SE: Somnolence, dizziness, GI upset, diplopia, ataxia, rash, thrombocytopenia, ↓ plt, hep, pancreatitis, ↑ wgt, ↑ hyperammonemic encephalopathy in pts w/ urea cycle disorders

Notes: Monitor LFTs & levels; trough: just before next dose; Therapeutic: Peak: 50-100 mcg/mL; Toxic Trough: >100 mcg/mL. Half-life: 5-20 h; phenobarbital & phenytoin may alter levels

Tri-Sprintec

Ortho-Tri-Cyclen®

BBW: Smoking may increase the risk of serious cardiovascular SE. This risk is increased in women >35 years old

Uses: *Contraception, acne vulgaris*, dysfunctional uterine bleeding, dysmenorrhea, endometriosis, PCOS

MOA: Suppresses LH and FSH, inhibiting ovulation; alters cervical mucusand endometrium

Dose: 1 tablet daily

Caution: X, +, w/ hepatic/renal impair, HTN, hyperlipdiemia, DM, gallbladder Dz

CI: Hx of breast CA or endometrial CA, active hepatic dz, cholestatic jaundice, uncontrolled HTN, Hx or risk factors of clot

Disp: Norgestimate 0.18 mg/ Ethinyl estradiol 35 mcg x 7 tabs, 0.215 mg/35 mcg x 7 tabs, 0.25 mg/35 mcg x 7 tabs, then 7 inert tabs

SE: bleeding irregularities, N/V, HA, breast tenderness, edema, wgt changes, depression, libido changes, glucose intolerance, elevated BP

Losartan potassium

Cozaar®

BBW: Can cause fatal injury and death if used in 2nd & 3rd trimesters. DC Rx if PRG detected

Uses: *HTN, DN, prevent CVA in HTN, and LVH*

MOA: Angiotensin II receptor antagonist

Dose: 25-50 mg PO daily-bid, max 100 mg; ↓ in elderly/hepatic impair

Caution: C/D/D, ?/-, w/ NSAIDs, w/ K+ sparing diuretics, supl may cause ↑ K+, w/ RAS, hepatic impair

CI: PRG, component sensitivity

Disp: Tabs 25, 50, 100 mg

SE: ↓ BP in pts on diuretics, ↑ K+, GI upset, facial/angioedema, dizziness, cough, weakness, ↓ renal fxn

Potassium Chloride ER

K-DUR®

Uses: Prevention or Rx of ↓ K+

MOA: K+ supl

Dose: 20-100 mEq/d PO ÷ daily-bid, IV 10-20 mEq/h, max 40 mEq/h & 150 mEq/d (monitor K+ levels frequently and in presence of continuous ECG monitoring w/ high dose IV

Caution: A, +, renal insuff, use w/ NSAIDs & ACE inhib

CI: ↑ K+

Disp: 8, 10, 20 mEq tabs

SE: GI irritation, ↓ HR, ↑ K+, heart block

Notes: Mix powder & liq w/ beverage (unsalted tomato juice, etc.), swallow SR tabs whole, monitor K+, Cl- salt OK w/ alkalosis, w/ acidosis use acetate, bicarbonate, citrate, or gluconate salt. Do not administer IV K+ undiluted

Phentermine

Adipex-P®

Uses: Short-term tx of obesity

MOA: Stimulates CNS activity; antiobesity agent

Dose: 18.75-37.5 mg PO qAM, 1-2 hrs before breakfast

Caution: C, -, elderly pts, HTN, DM

CI: PRG, Breastfeeding, CVD, HTN, glaucoma, Hx of drug abuse

Disp: Tabs 37.5

SE: palpitations, tachycardia, HTN, restlessness, insomnia, dizziness, euphoria, tremor, HA, xerostomia, constipation, D, itching

Notes: Do not crush or chew. May be split in half

Mirtazpine

Remeron®, Remeron® SoluTab

BBW: ↑ Risk of suicidal thinking and behavior in children, adolescents, and young adults w/ major depression and other psychological disorders. Not for peds

Uses: *Depression*

MOA: Alpha-2 antagonist antidepressant; ↑ NE & 5-HT

Dose: 15 mg PO hs, up to 45 mg/d

Caution: C, ?, has anticholesterol effects, w Sz, clonidine, CNS depressant use, CYP 1A2, 3A4 inducers/inhib

CI: MAOIs w/in 14 d

Disp: Tabs 15, 30, 45 mg: rapid dispersion tabs 15, 30, 45 mg

SE: Somnolence, ↑ cholesterol, constipation, xerostomia, wgt gain, agranulocytosis, ↓ BP, edema, musculoskeletal pain

Notes: Do not ↑ dose < q1-2 wks, handle rapid tabs w/ dry hands, do not cut or chew

Hydroxyzine

Atarax®, Vistaril®

Uses: *Anxiety, sedation, itching*

MOA: Antihistamine, antianxiety

Dose: Anxiety/sedation: 50-100 mg PO or IM qid or PRN (max 600 mg/d) Itching: 25-50 mg PO or IM tid-qid, ↓ w/ hepatic impair

Caution: C, +/-, ↑ effects w/ CNS depressants, anticholinergics, EtOH

CI: Component sensitivity

Disp: Tabs 10, 25, 50 mg; Caps 25, 50 mg; syrup 10 mg/5 mL; susp 25 mg/5 mL; Inj 25, 50mg/mL

SE: Drowsiness, anticholinergic effects

Notes: Used to potentiate narcotic effects; not for IV/SQ (thrombosis & digital gangrene possible)

Estradiol oral

Estrace®

BBW: ↑ Risk of endometrial CA; avoid in PRG

Uses: *Atrophic vaginitis, menopausal vasomotor Sxs, ↑ low estrogen levels, pallitation breast amd PCa*

MOA: Estrogen

Dose: PO: 1-2 mg/d, adjust PRN to control Sxs, Vaginal cream: 2-4 g/d x 2 wks, then 1 g 1-3x/wk. Vasomotor Sx/Vag Atrophy: 10-20 mg IM q4wk, DC or taper at 3-6 mo intervals. Hypoestrogenism: 10-20 mg IM q4wk. PCa: 30 mg IM q12wk

Caution: X, -

CI: Genital bleeding of unknown cause, breast CA, porphyria, estrogen-dependent tumors, thromboembolic disorders, thrombophlebitis, recent MI, hepatic impair

Disp: Tabs 0.5, 1, 2 mg

SE: N, HA, bloating, breast enlargement/tenderness, edema, ↑ triglycerides, venous thromboembolism, gallbladder Dz

Valacyclovir HCl

Valtrex®

Uses: *Herpes zoster, genital herpes, herpes labialis*

MOA: Prodrug of acyclovir, ↓ viral DNA replication. Spectrum: Herpes simplex I & II

Dose: Zoster: 1 g PO tid x 7 d. Genital herpes (initial episode): 1 g PO bidx 7-10 d, (recurrent): 500 mg PO bid x 3 d or 1 g PO qday x 5d. Herpes prophylaxis: 500-1000 mg/d. Herpes labialis: 2 g PO q12h x 1 d, ↓ w/ renal failure

Caution: B, +, ↑ CNS effects in elderly

Disp: Caplets 500, 1000 mg

SE: HA, GI upset, dizziness, pruritis, photophobia

Diclofenac sodium SR

Voltaren®

BBW: May ↑ risk of CV events & GI bleeding; CI in post-op CABG

Uses: *Athritis & pain, oral and topical actinic keratosis*

MOA: NSAID

Dose: 50-75 mg PO bid w/ food or milk

Caution: C, ?, CHF, HTN, renal/hepatic dysfunction & Hx PUD , asthma

CI: NSAID/aspirin ASA allergy, porphyria, following CABG

Disp: Tabs 50 mg, tabs DR 25, 50, 75, 100 mg, XR tabs 100 mg

SE: Abd cramps, heartburn, GI ulcerations, rash, intersitial nephritis

Notes: Do not crush tabs, watch for GI bleed, check CBC, LFTs periodically

Nitrofurantion monohydrate

MacroBid®

BBW: Pulm fibrosis possible

Uses: *Prophylaxis & Rx of UTI*

MOA: Bacteriocidal; interferes w/ carbohydrate metabolism. Spectrum: Some gram (+) & (-) bacteria: Pseudomonas, Serratia, & most Proteus resistant

Dose: Prophylaxis: 50-100 mg/d PO. Rx: 50-100 mg PO qid x 7 d. Macrobid: 100 mg PO bid x 7 d

Caution: B, +/not OK if child < 1 mo, avoid w/ CrCl <60 mL/min

CI: Renal failure, infants < 1 mo, PRG at term

Disp: Caps 25, 50, 100 mg; Susp 25 mg/5 mL

SE: GI effects, dyspnea, various acute/chronic pulm Rxns, peripheral neurpathy, hemolytic anemia w/ G6PD deficiency, rare aplastic anemia

Notes: Macrocrystals (Macrodantin) < N than other forms, not for comp UTI, may turn urine brown

Verapamil SR

Calan® SR

Uses: *Angina, HTN, PSVT, AF, A flutter*, migraine prophylaxis, hypertrophic cardiomyopathy, bipolar Dz

MOA: CCB

Dose: Arrhythmias: 5-10 mg in 15-30 min PRN (30 mg Max). Angina: 80-120 mg PO tid, ↑ 480 mg/24 h, max. HTN: 120-240 mg PO daily to 240 mg bid

Caution: C, +, amiodarone/beta-blockers/flecanide can cause ↓ HR statins, midazolam, tacrolimus, theophylline levels may be ↑; use w/ clonidine may cause severe ↓ HR w/ elderly pts

CI: Conduction disorders, cardiogenic shoch, Beta blockers/thiazide combo, dofetilide, pimozide, ranolazine

Disp: Caps 120, 180, 240, 360 mg

SE: Gingival hyperplasia, constipation, ↓ BP, bronchospasm, HR or conduction disturbances, ↓ BP and bradyarrhythmias taken w/ telithromycin

Venlafaxine ER

Effexor® XR

BBW: Monitor for worsening depression or emergence of suicidality, particularly in ped pts

Uses: *Depression, generalized anxiety, social anxiety disorder, panic disorder*, OCD, chronic fatigue synd, ADHD, autism

MOA: Potentiation of CNS neurotransmitter activity

Dose: 75-225 mg/d ÷ into 2-3 equal doses (IR) or qday (ER); 375 mg IR or 225 mg ER  max/d, ↓ w/ renal/hepatic impair

Caution: C, ?/-

CI: MAOIs

Disp: tabs IR 25, 37.5, 50, 75, 100 mg; ER caps 37.5, 75, 150 mg

SE: HTN, ↑ HR, HA, somnolence, GI upset, sexual dysfxn, actuates mania or Szs

Notes: Avoid EtOH